Evidence Says Diet + Physical Activity Programs Reduce Type 2 Diabetes

Have you wondered if diet and physical activity programs really help prevent or control type 2 diabetes? Then keep reading, because the Community Preventive Services Task Force (Task Force) released an evidence-based recommendation in favor of programs that actively encourage those at increased risk for type 2 diabetes to eat healthier and be more physically active.

What is the Task Force’s recommendation?

The Task Force recommends combined diet and physical activity promotion programs for people at increased risk of type 2 diabetes based on strong evidence of effectiveness in reducing new-onset diabetes. Combined diet and physical activity promotion programs also increase the likelihood of reverting to normoglycemia (normal blood sugar) and improve diabetes and cardiovascular disease risk factors, including overweight, high blood glucose, high blood pressure, and abnormal lipid profile.

Program participants may be considered at increased risk of type 2 diabetes if they have blood glucose levels that are abnormally elevated, but not high enough to be classified as type 2 diabetes.¹ Participants may also be identified using validated predictive diabetes risk scores.

The Task Force also concluded from the economic evidence that combined diet and physical activity promotion programs to prevent type 2 diabetes among people at increased risk, are cost-effective.

These effectiveness and economic reviews were conducted with oversight from the Task Force by scientists and subject matter experts from the Centers for Disease Control and Prevention (CDC) in collaboration with a wide range of government, academic, policy, and practice-based partners.

Peer-reviewed articles of the systematic reviews are not yet published; however, a summary of the findings and supporting materials are available on The Community Guide website.

¹People are classified as being at increased risk of type 2 diabetes if their blood glucose levels are abnormally elevated but still below the threshold for the disease. People at increased risk of diabetes have hemoglobin levels between 5.7% and 6.4%, fasting plasma glucose between 100 and 125 mg/dL, or plasma glucose between 140 and 199 mg/dL after a 75 gram oral glucose tolerance test (American Diabetes Association, 2010).

What are “combined diet and physical activity promotion programs”?

Combined diet and physical activity promotion programs aim to prevent type 2 diabetes among people who are at increased risk of the disease. These programs actively encourage people to improve their diet and increase their physical activity using the following:

• Trained providers in clinical or community settings who work directly with program participants for at least 6 months
• Some combination of counseling, coaching, and extended support
• Multiple sessions related to diet, physical activity, or both, delivered in-person, virtually through email or websites, or by other methods

Why is the Task Force recommendation important?

The number of people with diabetes and prediabetes continues to increase. It is critical that new cases of diabetes are prevented. The current facts are clear (CDC):

• 29 million Americans have diabetes; 8.1 million (27.8%) of whom don’t know they have it.
• 86 million Americans have prediabetes, but only 11% know they have it.
• Diabetes can lead to other serious health complications including heart disease, stroke, blindness, kidney failure, and lower extremity amputations
• Diabetes is the seventh leading cause of death in the U.S.
• Recent estimates show that direct and indirect costs for diabetes in the U.S. were $245 billion in 2012

What are the Task Force and The Community Guide?

• The Community Preventive Services Task Force (Task Force) is an independent, nonfederal, unpaid panel of public health and prevention experts. The Task Force works to improve the health of all Americans by providing evidence-based recommendations about community preventive programs, services, and policies to improve health. Its members represent a broad range of research, practice, and policy expertise in community prevention services, public health, health promotion, and disease prevention.
• The Guide to Community Preventive Services (The Community Guide) is a collection of all the evidence-based findings and recommendations of the Community Preventive Services Task Force and is available online at www.thecommunityguide.org.

For More Information

• The Community Guide – Diabetes Prevention and Control
• CDC, National Diabetes Prevention Program
• American Diabetes Association

References

Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services; 2014.